DESCRIPTION: (Adapted From The Investigator s Abstract): The long-term goal of this research is to determine the efficacy of pharmacologic modulation in the treatment of aphasia subsequent to stroke with oral doses of d-amphetamine (AMP). This is a double-blind parallel study of the use of AMP to modify or promote recovery from aphasia. This work is a critical extension of a large body of animal studies which have provided strong evidence related to the role of norepinephrine (NE) in central nervous system recover processes. The specific aims of the project are: (1) to determine the efficacy of using pharmacologic modulation in the treatment of aphasia following an occlusive left hemisphere stroke and (2) to provide evaluation of the drug treatment within a double-blind parallel design through a six- week drug treatment period and long-term follow-up. Efficacy will be evaluated by Overall Percentile Scores on the Porch Index of Communicative Abilities. Thirty-two patients will be studied over the three-year course of this study and receive either AMP or placebo over ten alternating treatment sessions and then be followed over 12 months. Additionally, patients will be described neurologically (NIH Stroke Scale) and radiologically (MRI) to further enhance understanding of possible relationships between response/nonresponse to drug therapy. The American Speech and Hearing Association Functional Assessment of Communication Skills (ASHA FACS) will be administered to assess functional communication. The debilitating effects of stroke and aphasia are long-term and represent a major adult health problem. To date, there has been no systematic pharmacologic therapy employed in rehabilitation of aphasia. If a relatively simple pharmacologic treatment with an established drug would be found to accelerate rate and/or extent of recovery from aphasia, it would have wide-reaching application.